Resolution of Migraine with Aura Post-PFO Closure in a Young Female: A Case Report
Abstract
Patient: Female, 35-year-old Final Diagnosis: Migrain aura • patent foramen ovale Symptoms: Migraine • nausea • pain • photophobia • vomiting Clinical Procedure: Echocardiography • EEG • magnetic resonance angiography of head and neck • magnetic resonance image • MRI • transesophageal echocardiogram Specialty: Cardiology • Neurology Objective: Congenital defects/diseases Background: Migraine, a prevalent primary headache disorder, often disrupts daily life, particularly when accompanied by visual auras. While the etiology of migraines remains elusive, emerging evidence suggests a correlation with cardiovascular anomalies. Case Report: This case involves a 35-year-old woman experiencing migraine with aura. Imaging studies, including MRI/A, revealed small-vessel ischemic damage in the right frontal region and historical microbleeds in the right occipital area. The patient’s RoPE score was a high 9 out of 10, and a grade 4 (severe) PFO was diagnosed following a TEE+bubble test. A transfemoral PFO closure was successfully performed using a 25-mm Amplatzer PFO occluder device via an antegrade transvenous approach without fluoroscopy. The patient was discharged in stable condition, with no migraine episodes reported at 5-month follow-up. The detection of PFO in young migraineurs, particularly those with aura, is crucial and warrants thorough investigation during their assessment and treatment. Conclusions: This case underscores the importance of incorporating cardiac evaluations…
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